with Blood from the little Arteries not that contained within themselves They are endowed with feeling both from themselves and sometimes from the Nerves Use is to receive the Blood not sufficiently elaborated from the Arteries and return it to the Heart and Liver there to be more perfectly concocted For the better Methods sake in the following we must be forced to describe all Veins here particularly and divide them into their Branches Vena Cava taking its beginning in the Liver as is before said is separated into the ascending Trunk and descending The Ascending which is the greater perforates the Diaphragm and is divided into four Branches of these 1. Phrenica which disperseth it self through the Diaphragma and Pericardium 2. Coronaria appropriated to the Basis of the Heart proceeds from the Trunk it self after it hath penetrated the Pericardium and inwardly united it self by a large fleshy Orifice to the right Auricle of the Heart 3. Azygos or sine pari coming from the right side of the same Trunk when ascending it hath passed the upper part of the Pericardium affording chief Branches to the eight lower Ribs then about the fleshy appendices of the Diaphragm it enters the Cavity of the lower Belly where on the left side 't is inserted into the Emulgent Vein on the right into the Trunk of the Cava 4. Subclavia from whom comes forth several Branches which go both upward and downward The Superiors are 1. Muscula Superior 2. Jugularis externa interna that on both sides sometimes single sometimes double goes to the Neck Head and Face this to the thick Meninx of the Brain to whose third Sinus its greater Branch is united The Inferiors are 1. Intercostalis serving the four upper Ribs and their Intercostal Muscles 2. Mammaria which is carried to the Breasts 3. Mediastina which goes to the Mediastine and Thyme 4. Cervicalis which goes to the Neck 5. Muscula inferior which goes to the Muscles of the Neck 6 7. Thoracica inferior and superior which goes to the Muscles of the Breast The Subclavials being come out of the Breast are called Axillares then go to the Arms where they are divided into 3 great branches which are 1. Cephalica in the hand between the little Finger and its next 't is named Salvatella Its Branches are variously mixt with the Branches of the Median 2. Basilica or Liver-Vein 3. Mediana which proceeds with other branches from the Basilica The descending Trunk which is the lesser and is undivided till it comes to the fourth Vertebra of the Loins then it communicates 1. Adipsosa to the Membranes of the Kidneys 2. Emulgens to the Kidneys themselves 3. Spermatica to the Testicles 4. Lumbares two three or four to the Loins and to their Vertebra's Nearer to the Os Sacrum it is separated into two Branches called Illiaci Before they go to the Feet the Trunk it self presents 1. Muscula Superior which goes to the Muscles of the Loins and Peritonaeum 2. Sacra sometimes single sometimes double to the Os sacrum 3. Muscula Media to the Buttocks 4. Hypogastria to the Bladder and its Neck to the Sphincter Ani to the Penis and to the neck of the Womb. 5. Epigastrica to the Muscles of the Abdomen and to the Peritonaeum 6. Pudenda to the privy Parts 7. Muscula Inferior to the joint of the Hips The Iliack Branches as soon as they have left the Cavity of the Belly are called Crurales From these proceed 1. Ischiatica minor which goes to the Skin and Muscles of the Hip. 2. Ischiatica major to the Hip then to all the Toes 3. Proplitea to the Ham. 4. Suralis to the Muscles of the Calf of the Leg. 5. Saphena To the Knee Ankle and to the upper part of the Foot and to the great Toe The Vena Cava where it comes out of the Heart receives three Valves called Tricuspidales looking internally for this purpose that the Blood may freely enter into the Heart but to hinder its return The Use of the Vena Cava is to receive the cruder Blood from the Arteries and remit it to the Heart Vena Porta much lesser and looser than the Vena Cava ariseth from the Umbilical Vein and with many Roots is inserted into the Liver without the Liver it is divided into Trunk and Branches all which are distributed into several Parts contain'd in the lower Belly From the Trunk proceeds 1. Gastroepiplois which goes to the Caul and Stomach 2. Intestinalis to the intestine Duodenum 3. Cysticae Gemellae to the Gall. 4. Gastrica minor to the left side of the Stomach Then this Trunk is divided into two great branches the Splenick and Mesenterick Ramus Splenicus sometimes joyning to the Sweet-bread sometimes passing through it divides into four little Branches as soon as it hath left it which are these 1. Vena Gastrica major which goes to the Spleen communicating from thence three or four small Veins to the Stomach These being blown up in living and dead Bodies manifestly declare nothing at all can enter into the Cavity of the Stomach so by consequence no Humor coming from the Spleen as long since Learned Men have imagined taught and writ seeing they terminate in the Coats of the Stomach and open not into the Cavity it self 2. Epiploica dextra 3. Coronaria stomachi 4. Epiploica sinistra Mesenterious ramus is also divided into four others of these the 1. Retains its old name and is distributed with fourteen or more Branches through the Mesentery 2. Vena Haemorrhoidalis and goes to the Spleen the Womb and the right Intestine 3. Vena Coecalis to the blind Intestine 4. Ramus Mesocolicus and goes to the Intestine call'd Colon. The Use of the Vena Porta is to take the Blood not sufficiently elaborated from the Arteries and carry it to the Liver for the perfecter concoction and for the separation of the Choler Venis pulmonalis which the Ancients corruptly call'd Arteria venosa seeing that it hath but only one Tunicle beats not of it self nor returns the Blood coming out of the left Ventricle of the Heart with a wide Orifice goes to the Lungs to receive the more imperfect Blood from the Pulmoniack Artery and carries it to the Heart About its egress from the Heart it hath two Miter-like Valves hindring the regress of the Blood to the Lungs It s Use is to carry the Blood received from the Pulmoniack Artery into the left Ventricle of the Heart Chirurgical Considerations 1. We have in another place treated of the Wounds of Veins we shall only add that if the Bandage by which you stay the bleednig be bound too hard it will easily induce a Gangrene 2. We have admitted only four general Indications of Bleeding to wit for the Refrigeration Imminution Revulsion and Derivation of the Blood but special Diseases requiring one Vein to be chosen before the other which are these following in a Delirium and great pain of the Head the Vein of the Forehead or
Praeparata or Vena puppis may be cut sometimes the Temporal or Saphena In an Inflamation of the Eyes the Cephalica and if you desire to evacuate from the whole Body the Basilica or Mediana In a Quinsie the Ranina which must be but with a little Incision seeing we cannot scarce by any means stop the Flux of Blood and sometimes also the External Jugular In a Pleurisie the Basilica of the affected not opposite side here is requisite the greatest Circumspection for under it lies the Tendons of the Muscle Biceps and near it the Artery In anger fear or any Casualty c. the Mediana or Basilica In Chronick Diseases and quartane Fevers the Salvatella especially in the Full and New Moon In Women that lie in and in suppression of the Menses the Saphena In the Sciatica the Ischiatica CHAP. IX Of Arteries AN Artery is a Similar Spermatick Membranous round cavous Part joined every where to the Veins by the assistance of its Oscultations containing the Nutritious Blood with the Vital Spirit carrying it to all the Parts of the Body Difference is two-fold the great Artery or Aorta and Pulmoniack The great Artery comes from the left Ventricle of the Heart which except in the Brain and other softer parts every where else consists of a double Coat the outermost of which is of the thickness of the Veins but the inmost is five times thicker lest by continual pulsation about the hard and solid Parts it might incur an incurable Rupture It receives three Valves call'd Sigmoides looking outwardly Coming out of the Ventricle of the Heart with a great Orifice before it perforates the Pericardium it affords to the Heart it self the Coronary Artery when past the Pericardium it is divided into the Ascending and Descending Trunk The Ascending Trunk which is the lesser resting upon the Wind-pipe is separated into the two Subclavials from which being yet within the Breast proceeds 1. Intercostalis superior proper to the four upper Ribs 2. Mammaria to the Breasts 3. Cervicalis to the Muscles of the Neck 4. Carotis externa interna proper to the Larinx Tongue Neck Head and Brain When they have left the Thorax they are called Axillares and carry Nourishment to the outward part of the Breast 1 2. By the Thoracica superior inferior 3. By the Scapularis 4. By the Humeraria Then they approach the Arm where they accompany the Branches of Vena Cava and are call'd by the same name as they are The Descending Trunk which is the greater being yet within the Breast sends 1. The Intercostalis superior to the eight lower Ribs 2. The Phrenica to the Diaphragm and Pericardium Then having perforated the Diaphragm it communicates 1. The Coeliaca to the Stomach from which proceeds the Splenica and Gastro Epiploica dextra 2 3. Mesenterica superior inferior to the Mesentery 4. Emulgens to the Kidneys 5. Spermatica to the Testicles 6. Lumbaris to the Loins 7. Muscula superior to the Muscles of the Abdomen Then at length it is divided into the two Iliac Branches About this Division exhibiting 1. Muscula superior 2. Epigastrica 3. Hypogastrica 4. Umbilicalis 5. Pudenda Out of the Abdomen they change their names and are call'd Crurales and so they descend into the Feet and all along accompanied with the Veins from whom they borrow their Names Use is to carry the nutritious Blood with the Vital Spirit into all parts Arteria Pulmonalis which the Ancients did falsly call Vena Arteriosa seeing it hath Pulsation is made up of a double Coat and contains the Nutrious Blood issuing out of the left Ventriticle of the Heart with a double Branch enters the Lungs and is distributed through them by many little Branches carrying to them the Nutritious Blood And then what in the Blood is not sufficiently concocted into the Pulmoniack Vein by whose means 't is returned into the left Ventricle of the Heart It hath three Valves called Sigmoides which look outward lest the Blood that having entred it should slide back again into the Ventricle of the Heart It s Use is to convey the Blood out of the right Ventricle of the Heart into the Lungs by which they are nourished and what remains above then serves for their Nutriment is brought back again by the Pulmoniack Vein into the left Ventricle of the Heart Here it pleaseth the curious Observers of Anatomy to take notice of besides the eleven Valves which we have declared to be disposed in the four already named Vessels that many others are found in the Heart which as yet want any certain name Chirurgical Consideration In an Haemorrage of the Nose the Blood flows from the Arteries not Veins which not only the colour of the Blood witnesseth but also the great weakness which always follows such a Flux I use to stay it after this manner First let a Vein be opened then let there be applied in Men to the Testicles in Women to the Hypogastrium a Linnen Cloth four double wet in cold water or let the Face of the Patient be suddenly sprinkled with cold Water Internally let there be exhibited now and then a spoonful of the following Mixture Take Plantain-water two ounces and an half Alexipharmick-water half an ounce Cinamon-water three drams Confection of Hyacinth half a dram Dragons Blood Lapis Haematitis of each fifteen grains Julep of Roses an ounce Laudanum Opiat two grains Spirit of Vitriol six drops Mix them The following Water is also commended Take Lapis Prunella half an ounce Plantain-water six ounces let it be divided into three Doses The manner of opening Arteâ—ies delivered by the Ancients is so dangerous and frightful as that there is none of the Moderns but what dislike it yea Arteriotomy hath been wholly rejected had not the Diligence of their Posterity found out other ways That which I with others have found always to be the best of them I will here set down Chirurgeons were wont to tie a Bandage about the Neck but seeing when it is hard bound it is very troublesome it is better that the Ligature be made under the Arm-pits which must be so straight that the Jugular Veins and Carotide Artery may appear both by swelling and touch then let the Arteries be compressed by the Thumb a little below where you intend to make the Incision and being opened which must be done by a steddy and strong hand take forth as much Blood as is sufficient which done strew Astringent Powder upon the Wound then put over it a double Linnen Cloth with a Plate of Lead then bind it up with a convenient Bandage and within five or six days space it will be perfectly well In the Head-ach Madness Epilepsie great Inflamations of the Eyes or Ears the Arteries of the Forehead Temples or those behind the Ears are opened as also the Arteria puppis all of them being branches of the external Carotide In the Inflammations of the Liver and Diaphragm the Artery between the
of the Flesh is taken away and then 't is call'd a compound or hollow Wound 3. From the Causes which shall presently be set down sometimes a wound happens to be poisoned and to have many Symptoms joined with it Causes are five-fold viz. 1. All things that cut as a Knife Sword Glass 2. Al things that prick as Needles Arrows Teeth 3. Which perforate as hot Iron Bullets 4. Which break as a Fall Stroke or the carrying or lifting of any great Burdens 5. All things which contuse as a Stone Stick c. Signs External Wounds are of themselves manifest enough but those of the Internal parts are not always so easily judged of these therefore are to be known by Anatomy 1. What is the situation of each part 2. What the use 3. The Symptoms are to be considered 4. The Quality of those things are to be noted that Nature ejected through the Wound The other Signs you shall have in their proper places Prognosticks To know the Events of Wounds especially to predict which are Mortal which not is a thing absolutely necessary for a Surgeon For from this judgment oft-times depends the Life of unfortunate Man A mortal Wound is that which in the space of few hours or days of necessity causes Death and cannot by any Art be cured For those that in themselves are curable yet by reason of ill Symptoms or through the neglect either of the Patient or Chirurgeon do occasion Death ought not to be accounted mortal Wounds Incurable Wounds themselves are not to be call'd Mortal if they are not the cause of Death suddenly to the Patient but that he not only lives many weeks but oftentimes many years after 1. Among the Wounds that are Mortal are to be accounted the Wounds of the Brain but not all of them for Experience hath taught us that part of the Brain hath been taken forth and the Life preserved though the Understanding lost Therefore those Wounds of the Brain that be absolutely mortal are 1. When besides the Brains a Nerve is also wounded 2. When Blood or some other Humor obstructs the beginning of the Nerves 3. When after a few days the concrete and putrified Blood produceth a Fever Delirium and Death it self By concreted Blood I understand not that which lies between the Dura-Mater and the Skull for that is to be taken forth by the Trepan and the Patient this way may be preserved but that which is included between the Dura and Pia-Mater or between the Pia and the Brain Although sometimes that which is detained between both Membranes by the dividing of the Dura may be taken forth and so the Patient preserved 2. The Wounds of the Spinal Marrow are also mortal which happens in the Neck or nearer to the Head but those which happen lower as about the Os Sacrum are of lesser danger 3. The Wounds of the Lungs are mortal if great and deep where the great Vessels or the Branches of the Aspera Arteria are hurt Where the Vessels are divided there follows a great effusion of Blood where the Branches of the Aspera Arteria the Breath comes forth more through the Wound than the Mouth 4. Wounds of the heart are always mortal for though one or two wounded in the heart have lived two three or four days it was never found yet that ever any escaped 5. The Wound of the Wind-pipe may be cured if the Membranes only behind to which the Cartilaginous Rings are join'd be hurt but if the Rings themselves are wounded there 's no cure to be expected yet sometimes those wounds being a lingering Death so that I have seen on so wounded live Eighteen weeks before he died 6. Wounds of the Diaphragma those that are inflicted in the fleshy Part of it are curable but those that are in the Nervous Part though these always occasion not sudden Death yet 't is impossible ever to cure them 7. Wounds of the Stomach are sometimes cured those chiefly being mortal that happen in the upper Orifice or in Nerves that are distributed over the Stomach 8. The Wounds of the Small Guts are seldom cured but the Wounds of the Great Guts much oftner especially if they are not great 9. Wounds of the Liver and Spleen are mortal where the Vessels themselves are wounded where not they may be cured 10. Wounds of the Kidneys are not mortal if the Wound penetrate into the Cavity it self for the most part an Ulcer follows which consumes the whole Kidney yet the Patient may continue many years If the Parachyma only be wounded sometimes through difficulty it may be cured 11. Wounds of the Bladder are seldom so perfectly cured but that for the most part there remains a Fistula but those that are made at the neck of the bladder are daily cured 12. Wounds of the great Veins and Arteries are often mortal but every Surgeon understands not rightly to bind up such Wounds therefore the cause of death is not always to be cast upon the guilty 13. Wounds of the great Nerves are for the most part incurable and sometimes mortal 14. Wounds from poisoned Instruments or Creatures generally are mortal Wounds of Nerves Veins Tendons and Membranes are more difficultly and longer of Cure than those of the fleshy parts A Wound from a pricking Instrument is of less danger than from a bruising A Nerve Vein or Artery if wholly divided are less dangerous than if they were but in part A great Inflamation coming upon a great Wound is of no great danger except it continue too long but a great Inflamation falling upon a little Wound is an ill sign The Inflamation for the most part vanisheth by the fifth day therefore if the Wound then appear white livid or black 't is not void of danger A Fever Vomiting and Convulsion are dangerous but a Fever and Vomiting of less danger than a Convulsion CHAP. II. Of the Cure of Wounds in general HEre are required four Intentions 1. To preserve the strength and native heat of the wounded Part. 2. To remove the Symptoms 3. To endeavour that nothing remains or be left behind in the Wound 4. That the gaping Lips of the Wound be joined together and being so joined be kept CHAP. III. Of the preservation of the strength and Native heat in the wounded Part. CHirurgery removes the impediments of Cure but Nature her self cures the Disease which it will scarce effect where the Native heat is weak or the Blood vitiated or where it flows in too great or too little quantity to the Wound in flowing in too great quantity it produceth an Inflammation Pain Putrefaction and many other Symptoms where in too little quantity the Wound is robbed of its Natural Balsam necessary to consolidate it The natural strength and native heat is preserved by a convenient Diet fitted to the temperament of Mans body in general and in particular to the Part affected Of the Diet of the Sanguine Cholerick Phlegmatick and Melancholick we have treated of before
through the Belly The Venae Lacteae consist of one very thin Tunicle but are endowed with several Valves extended from the Liver towards the Glandules they are distributed through all the Mesentery and so are carried for the most part to the small Guts especially the Jejunum but yet the great Guts are not altogether destitute of them that none of the Nutriment may be lost From the Intestine both these Vessels and the Chile contain'd in them go to the three Glandules of the Chile the greatest of which is in the middle of the Mesentery called by Asellius Pancreas the two lesser are call'd the Lumbar Glandules situate near the left Kidney Each of these Glandules send forth a Branch which joining above the left Kidney constitutes a Vessel called Vena Lactea about the bigness of a great quill This great Lactean Vein lying between the Arteria aorta and the Vertebra's of the Loins cover'd with Fat runs upwards and above the Heart ascends by the Gullet and so hastens to the left Subclavial Vein where it ends in one two or three branches here a most thin valve occurs at the very end of the Vein looking inwardly that the Chyle might not return back again or run further into the Arm out of this Subclavial they descend by the ascending Trunk of Vena Cava into the right Ventricle of the Heart that there by the help of the heat and natural quality it may be changed into Blood Being converted into Blood it passeth by the Pulmoniack Artery to the Lungs which are by part of it nourished and the rest of it goes through the Pulmoniack Vein to the left Ventricle of the Heart that it may be more perfectly elaborated thence by the great Artery is carried to all the parts of the Body communicating to them nourishment for the preservation of Life These ways of Conveyance is displeasing to some who would rather retain that by the Mesaraick veins known and so greatly cried up by the Ancients than admit of a new Truth therefore they say that the Chile together with the Blood may by this way be most conveniently carryed to the Liver seeing that the Venal Blood is carried not from the Liver to the Guts which was the false Opinion of the Ancients but from the Guts to the Liver and so not here to be allowed a contrary motion of each Liquor already sufficiently known But in truth these Opinions they defend rather by a probable Ratiocination out of their old affection to the Liver than that they can make it out by natural or demonstrative Arguments or answer these Queries following 1. What is the use of the Lacteal Veins 2. Why is their rise in the Guts 3. Why the Valves are so placed that they may hinder the regress of the Chile into the Guts 4. Why do they all go together with the Chile to the Glandule of the Chile and none of them to the Liver 5. Why are the great Lacteal Veins joyned together 6. For what end doth the Chile pass into the Subclavial Veins All which can be made appear in the Body to the sight That part of the Blood which is not altogether useless yet not fit for Nutrition passeth out of the Arteries ever joyned together by Inosculations with the Veins into the Vena Cava and Porta and so by their means is brought again into the Liver and Heart that it may be amended and again concocted I do not only say that the Blood is carried by the Vena Cava into the Heart but also by the Vena Porta into the Liver which I prove by these Reasons 1. The Liver is the biggest of all the Viscera not that I would infer its pre-eminence from its greatness see Chap. 2. but I suppose Nature would never have created so great a Body but for the performing of some extraordinary operation 2. It s greatest Vein coming out with a large Orifice forthwith goes to and enters the Heart What necessity is there for the Vena Cava to be distributed with such numerous Branches through the Liver and so presently to ascend into the Heart for indeed it ought to convey back the Blood not amended It s Trunk likewise and that of the Arteria Aorta might ascend directly up the Body to the Heart without concerning it self with the Liver especially when the Vena Porta near the Liver may also yield sufficient ways for freeing all the Blood from Choler It ought to receive the Blood concocted in the Liver and convey the same to the Heart 3. It s colour is red I well know that it is sometimes observed to be white pallid yellow green but this colour is to be ascribed to the Disease not to its natural Constitution for in all Bodies perfectly sound it is found red What wonder is it that the Liver being red in weakness should contract a whiteness doth not a red face grow pale when the Body is affected with sickness How easily likewise that the Liver separating the Choler should be died with a yellow or green colour 'T is also observed in the first xx or xxx days after conception it is naturally white neither becomes red before the maternal Blood concerning which some of the Moderns have far otherwise ascribed comes to the nourishment of the already formed parts which is the same in all Spermatick parts even in the Heart it self But will you conclude from hence that this red colour only happens to the Liver and is not more proper to it than it is to the Muscles which yet therefore do not make Blood To this I answer that the affluent Blood is so necessary here and so appropriated to the Liver that without it it cannot be called a perfect Liver but both the colour substance and number of Vessels are so difierent in a Muscle and in the Liver that in no wise the parts deserve to be said to be like one another and what absurdity is it to say that a Muscle sanguifies when even the Heart it self by the principal Anatomists and Philosophers is acknowledged a Muscle 4. The Maternal Blood comes first up the Umbilical Vein to the Liver ere it goes to the Heart of the Infant And the Valves and Ligatures evidently demonstrate that the Arterial Blood is carried by the Umbilick Arteries from the Child to the Womb but the Venal by the Umbilick Vein from the Womb to the Child but whether the Infant is nourished by the Maternal Blood or by an External Humor like as a Chicken in the Egg is to me all one when 't is evident the Blood which either coming from the Mother or Infant passeth first to the Liver before it enters the Heart 5. The Choler is separated from the Blood in the Liver for every one knows that there can no separation be made without there be first a Concoction From all these Arguments I cannot gather any thing but that the returning Blood is carried by the Vena Porta to the Liver that it may there
be purified and in some manner concocted in which its operation that the Blood may be rendred more perfect 't is carried to the Heart especially when by reason of its continual and necessary Pulsation the Blood cannot remain long in the Heart and for this reason I judge the whole Blood must needs be moved about with a circular motion The Blood made in the Liver as is declared but now in the eighth Chapter enters the Vena Cava and from thence into the Heart And thus the Royal Liver at the same time when Kings are taken away may yet use a limited power and may remain with honour in its own Kingdom But what shall we do with the Melancholick Spleen which makes many laugh It hath many accusers and not fewer excusers 1. It was never accounted by Hippocrates the Learned Greek a receptacle of the Excrements or is it any where to be found in him that he call'd the Spleen another Liver 2. The great number of Veins and Arteries and so by consequence the abundance of Vital Spirits do not permit the Excrements to be collected here 3. It hath not any convenient Cavity wherein the Melancholy Faeculent Juice can be received 4. And if you imagine that there is no necessity here of a Cavity its Parenchyma is too thick and not porous enough therefore unfit for the reception of so thick a Humor which also is never naturally found in it 5. It is too great a Bowel to perform so vile an Office 6. In dead men where Melancholiness hath been the cause of their death upon the examination of the Internal parts there none of them less recede from its natural state than the Spleen the Heart only excepted whom the Vital Spirits do so greatly defend that it is less affected than other parts which seldom happen to the Intestines Kidneys Gall and Bladder What is therefore its Use It elaborates the Acid Humor which is very necessary but not Excrementitious and mingles it as a Ferment with the Blood by which it becomes more perfect and fitter for Circulation In my judgment the Salt of the Blood affords matter to this Humor which it greatly requires that it may not be corrupted but this Salt which proceeds from the Meat and drink is never so pure but that it hath need to be brought to a more perfect state in our Body But this is my Opinion The Supremest of the Kings is the Heart to this are two others subject the Liver and Spleen I beseech you give me leave to make use of this Similitude in favour of the Ancients the Heart makes the Blood the Liver repeats the Concoction and separates the Choler the Spleen from its own Salt by an innate vigor produceth an Acid Humor which as a Ferment by the Venal Splenic Branch it mixeth with the Blood to render it the perfecter and the more fit for Circulation if any Excrementitious part should be there separated it is all by the Caeliack Artery and the Haemorrhodal Vessels sent to the Guts If it appears to any one to be a contradictory that by Salt a Humor should be made Acid we advise that person to taste some Spirit of Salt About sixteen years since the great Anatomist Franciscus Sylvius put forth some particular things concerning the use of the Spleen he was of opinion that the Blood was not made in the Ventricles of the Heart neither that it was carried from the Heart by the Arteries to all the parts of the Body for nourishment-sake alone but that it likewise underwent some other Mutation in the rest of the Viscera's particularly that the Spleen further concocts the Arterial Blood and brings it to a higher degree yea that it more then perfects it so that the Blood in a manner in this place assumes the nature of Ferment by whose means in a short time a great quantity of Mass may become acid in the same manner he affirms that the Blood more and more concocted in the Spleen there receives strength by which it restores the returned and weakned Blood and preparing together with it the Chile that it may the sooner be turned into Blood The Reasons which he produceth for it are these 1. The Spleen receives a much greater quantity of Blood from the Heart than is necessary for its nourishment 2. That it can be returned back again to the Heart by no other way than by the Branches of the Vena Cava and Porta for what hath hitherto been delivered of the short Vessel are to be accounted but ridiculous Fictions as may most evidently be made appear in dissected Bodies 3. Seeing this Blood is continually mix'd with the returned Blood and Chile in its passage to the Heart it ought not to be an Excrement for so the Noble Parts and the whole Body would not be purged but the more injured 4. Chymistry hath long since taught us that such mutations happen daily in Nature The Remaining Part of the Blood unuseful to the Body therefore Excrementious is thrown out through the Guts Ureters and Parts of the Skin c. concerning which it is not necessary to add more here but now we are forced to describe those new watry passages which the studious in Anatomy have long and diligently inquired into The watery passages the Lymphatick Vessels have their rise both from the Liver and from the Joints and receive the liquid Juice from the Arteries with which they correspond Those which come from the Liver embrace the Vena Porta and so pass to the Misaraick Glandules of the Chile as do those also that ascend from the Feet thence they discharge their Water into the great Lacteal Vein which as we have already declared carries the Chile to the Heart Those which proceed from the Arm both lie above and under the Veins until they come to the Subclavial Vein which they enter about the same place where the great Lacteal Vein doth being furnished with a particular Valve just at their entrance and so altogether they carry the Water to the Heart This Water is Sweet not being as Urine is Salt These Vessels consist of a very thin Tunicle whence they are soon broke Use of them in my opinion is to take the superfluous Water from the Arteries and carry it to the Glandules of the Chile and Lacteal Vein by which the Chile being made more Liquid may the more conveniently be conveyed through the narrower passages thence to return the same to the Arterial Blood making it fitting to serve to the nutrition of the moist parts and to the cooling and moistening of the hot But that it may the more clearly appear in what manner I conceive how what hath already been said is perform'd in our Body observe that the Meat is converted in the Stomach into Chile to which part of the Drink is mingled this mixture is carried through the Glandules of the Chile and the great Lacteal Vein into the Heart where it is changed into Blood which is by means of
in one days space with compound Ointment of Marshmallows the watry matter being suckt out by a Woman or Whelp but this discharge being neglected or delayed every day the Breast grows harder and harder nay becomes enflamed then Bleeding Purging Sweating is requisite Outwardly this Cataplasm may be applied Take meal of Marshmallows of Fenugreek of each an ounce Flowers of Elders Camomile of each an handful red Roses two pugils Crums of course Bread an ounce and half Boil them in Ale adding to them of Rose-Vinegar an ounce Make a Cataplasm The Flux of Humors and Pain being ceased the remaining may be discussed by the following Cataplasm Take Meal of Beans of Linseed and Fenugreek-seed of each an ounce Cummin-seed three drams boil them in Wine adding to it compound Ointment of Marshmallows Oyl of Camomile of each half an ounce Make it into a Cataplasm When it begins to apostumate Maturatives are to be used Take Leaves of Mallows Marshmallows of each a handful Powder of Linseed an ounce of Fenugreek-seed an ounce and half Leaven half an ounce boil them in Milk adding to them Vnguentum Basilicon an ounce Saffron a scruple Make it into a Cataplasm The Tumor being suppurated must be opened with a Caustick or what is better with a Launcet and put a Tent into it dipt in common Balsom of Brimstone until the end of the Cure laying upon the Breast Emplastrum Diasulphuris Bulandi 3. A Gibbosity ariseth from the spine of the Back when the Vertebra's are removed outwardly or of one side from their natural place which is occasioned sometimes by an External Cause some by an Internal especially when some pituitous Humor is collected about them this Humor must be taken away by discussive Oyl and Plaisters before what is started out can by a Steel-compress fitted to the Body of the Patient be reduced This reduction is not so much performed by the Compress as it is by the Emollient quality of the Iron For this reason it is necessary that the Patient though cured for a year or more after use another Bandage that the soft Bones may not again start out It is here likewise to be observed that in the middle of the Back about the seventh Vertebra with great success may an Issue be made to intercept Rheums flowing to the Hip Kidneys Feet c. CHAP. II. Of the Internal Parts of the Thorax THe Breast now comes to be opened that we may view the Fountain of Life which the Celestial Truth affirms to consist in the Blood for what reason is it therefore that the Sovereign Sanguification is not attributed to the Heart where every where and by all it is call'd the Original of Life Within the Breast is invested by the Pleura which is afterward doubled and at length quadrupled extending it self from the Vertebra's to the Sternum and then it is called Mediastinum dividing the Lungs and Thorax Near to the Throat there adheres to the Mediastinum a Glandulous Body call'd Thymus The Lungs drawing in the Air so cooling the Heart is furnished to this purpose with a Trachea Aspera Arteria or Wind-pipe this lies upon the Gullet and consists of Cartilaginous Rings and a double Membrane The outermost of these Membranes which is the thinner ariseth from the Pleura the innermost which is the thicker from the Dura Mater The annulary Cartilages are joyned together with Ligaments and make not a perfect Circle as being destitute of a fourth part that lies upon the Gullet The Wind-pipe distributes Branches through the whole Lungs which are strong enough but not at all Cartaliginous The Lungs themselves covered with a thin porous Tunicle consist of a soft red spongy substance In the fore-part they adhere to the Sternum in the back-part to the Vertebra's filling the greatest part of the Breast It hath seven lesser Vessels of which we shall speak in their places The Heart the Work-house of the Blood the Fountain and Origin of Life as the Sacred Writ it self also witnesseth is included in a certain Case call'd by Anatomists Pericardium It consists of two Membranes the outermost comes from the Mediastinum the innermost from the Vessels of the Heart it contains a clear watry Liquor void of all Acrimony which we no longer doubt of to be brought from the Ductus's of the Limpha The Heart it self consists of a fleshy serene and hard substance which is invested with a proper Tunicle furnished with Fibres of all sorts and like a Muscle is continually moved It is placed in the middle of the Breast but the point of it inclines sometimes to the left side In Figure it is like to a Pine-Apple having in its upper part two Auricles or little Ears which alwayes beat before the Heart it self In old people the right Auricle is bigger than the left which in Infants is the contrary in the throwing forth of the Blood the Auricles as well as the Heart it self are purst together and dilated as often as they take in the Blood and this Constriction and Dilation makes the Pulse For the concoction reception and throwing forth of the Blood it hath two Cavities and four Vessels The Cavities are distinguished by a fleshy Division in which I could not yet find any way appointed for the motion of the Blood out of the right Ventricle into the left although many Anatomists do certainly affirm it These Cavities are divided into the right and left the right which is the greater receives the Vena Cava and Arteria pulmonalis or Vena Arteriosa the left which is the least receives the Arteria aorta or great Artery and Vena pulmonalis or Arteria venosa Of these Vessels as also of the Nerves and Chylous passages or the Thoracick lacteal Veins we have treated of in the first Book Under the Wind-pipe in the Cavity of the Breast lies the Oesophagus or Gullet resting upon the Vertebra's About the fifth Vertebra of the Back it inclines a little to the right side that it may give way to the Arteria aorta unto the eleventh Vertebra thence with a straight Ductus it passeth the Diaphragm into the lower Belly It consists of a double Membrane the outermost is fleshy having streight and round Fibres the innermost transverse and oblique Many add to these a third from the Peritonaeum and rightly in my opinion The Diaphragm in nature of a Fan serving to respiration divides the Thorax from the Abdomen and adheres to all the Bastard-Ribs to the Cartilage of the Breast-bone about the Vertebra's sending two fleshy Processes to the lower parts Its edges round about are fleshy variously movable like a Muscle but its Center Membranous and very sensible It hath three perforations 1. In the middle of it through which the Vena Cava passeth 2. In the left side through which the Gullet with the adjacent Nerves 3. About the Vertebra's for the passage of the Arteria aorta with the Vena azygos It receives more Nerves than any other part of
c. pag. 101 Scraping 37 how it s performed on the Bones pag. 65 Scrotum its watry Tumor how cured by Paracentesis pag. 51 Secundine its extraction pag. 74 Seton where how c. to be made pag. 71 Shortness of Breath pag. 280 Shoulder-Blade Broken pag. 13 Sinchondrosis pag. 208 Sincurosis Ibid. Skull and its parts 209. its Fractures 10. its Bones and Sutures pag. 209 Sphacelus its Causes Signs Cure c. pag. 116 Sparmatocele pag. 34 Spermatick Vessels pag. 319 Spinal Marrow pag. 293 Spittle its use matter c. pag. 250 Spleen its Wound pag. 175 Sternum pag. 208 Stitching in cure of Wounds how to be performed pag. 160 Sticking-Plaister pag. 161 Stomach its History pag. 315 Stone in the Bladder cause sign c. 83. its Extraction pag. 82 Suture pag. 208 Sumphysis Ibid. Synerthosis Ibid. Synthesis what it is pag. 1 Syssarcosis pag. 208 T. TAlus pag. 338 Tarsus and its Bones pag. 211 Teeth how many c. 273. their pain its cause and cure 282. their Breeding in Children how remedied pag. 284 Temperaments of men described pag. 202 203 Temples what pag. 268 Terebration 37. How performed pag. 67 Testes of the Brain pag. 294 Testicles of men 320. in Women 321. Inflamed 326. Cancer Sphacelus pag. 327 328 Thigh 210. Broken 15. Dislocated pag. 24 Thorns things to draw them out of a Wound pag. 158 Tibia 210. It s Fracture pag. 16 Timpanum pag. 276 Tongue-tied the Cure pag. 47 Tophs pag. 214 Tumor its Causes c. 88. Flatulent its Cause Cure c. pag. 107 Tunicle conjunctiva Adnata Retina Aranea Cornea Vitrea Vvea 274. Elytroides Erithroides Albuginea pag. 320 V. VAlves of the Vena Cava 225. of Vena Pulmonalis 226 of the great Artery 228. of Arteria Pulmonalis pag. 230 Veins their difference 221. Adiposa 224. Atteriosa 230. Axillares 224. Azygos 223. Basilica 224. Cava and its distribution 222. Cephalica Cervicalis 224. Coronaria Stomachi 226. Cordis 223. Emulgens 224. Epigastrica Ibid. Gastrica minor 225. Major 226. Gastroepiloris 225. Haemorrhoidalis 226. Hypogastrica 224. Intercostalis Jugularis 223. Intestinalis Ischiatica 225. Lactea Magna 253. Lumbaris 224. Mammaria 223. Mediastina 223 Mediana 224. Mesenterica Mesocolica 226. Muscula inferior superior 223. Phrenica ibid. Poplitea Porta 225. Pulmonalis 226. Saphena 225. Spermatica Salvatella 224. Subclavia 223. Splenica 226. Thoracica 224. Vmbilicalis 314. which to be cut in particular Diseases pag. 227 Venters of the Body what and how many pag. 266 Ventricles of the Brain 294. of the Heart pag. 307 Vertebra's of the Neck 210 297. of the Loyns 312 of the Abdomen of the Back pag. 210 Vlcers their difference causes signs cure 177 178. with foul Bones their cause sign cure 182. Spreading and Malignant 184. Fistulous 186. of the Eyes 194. of the Legs 199. of the Nose 195. of the Bladder 197. of the Womb 199. Vlcerous Excrescency pag. 211 Vnition pag. 2 Vreter 319. Exulcerated pag. 325 Vrethra pag. 321 W. WAtry Passages 261. Tumor pag. 103 Wind Medicines discussing it pag. 108 Womb its History 322. inflamed c. 329. its falling down 34. Haemorrhoides 330. whether it can be taken away pag. 329 Worms in the Pericranium in the Bladder their Remedies pag. 325 Wounds their difference causes signs c. 147. their symptoms and cure 153. of the Stomach their cure 174. which are mortal 149. their Lips how to be joyned 159. of the Ears and Lips 173. of the Head and Brain 172. of Heart 174. of the Face 172. of the Guts 175. of the Liver and Spleen 175. of the Nerves their causes c. 166. of the Eyes 173. of the Lungs Ib. of the Kidneys 176. Made by Gun-shut 168. of the Tendons 166 Poysoned 170. of the Bladder pag. 176 Wrenching pag. 17 Y. YArd pag. 321 FINIS MEDICINA MILITARIS OR A BOBY OF MILITARY MEDICINES Experimented BY Raymundus Mindererus Late Chief Physician of the Electoral Court of Bavaria and of the Imperial City of Aspurg Englished out of High-Dutch LONDON Printed for Charles Shortgrave at the Turk's-Head in St. Paul's Church-Yard 1686. CISTA MILITARIS OR A Military Chest Furnished Either for SEA or LAND With Convenient MEDICINES and necessary INSTRUMENTS Amongst which is also a Description of Dr. LOWER'S LANCET for the more safe Bleeding Written in Latine By Gulielmus Fabritius Hildanus Englished for publick Benefit LONDON Printed for Charles Shortgrave at the Turk's-Head in St. Paul's Church-Yard 1686. A Description of a LANCET FOR The more secure Letting of BLOOD By Dr. LOWER FOrasmuch as it hath been thought convenient by several good Chirurgeons to contrive a safe way of Blood-letting for the benefit of young Beginners in that Profession and whereas Dr. LOWER of late in his Treatise of the Heart hath discovered a plain and secure way of Bleeding and given a figure of the Lancet which he commends for that purpose I have been advised for the publick Good to translate what he hath written and likewise give the figure of the Lancet and description of the Use of it as it is printed in the 166 page of the last and truest Edition of his Book Printed at Amsterdam 1671. in the Author 's own words HOw great Ebullition sometimes happens in the Blood in what vessels and with what swift motion it is cast about every where through the Body and if an Artery be opened how quickly and with what force it breaks out it hath been hitherto treated of in the foregoing Discourse by which it appears how necessary sometimes Blood-letting is to diminish its Quantity or to stop its Career and how dangerous the Administration of it is if it be performed by a rude and unskilful hand For it often happening either by want of skill or common practice of Bleeding which makes the Mind fearful and consequently the Hand trembling and uncertain that an Artery is opened or a Nerve or Tendon cut or prick'd whence follows Swellings Pains Inflammations Gangrenes or Convulsions which put the member in danger of being cut off or render'd useless I thought it might not be beyond the scope of my Treatise if by way of Appendix I should shew by what means and Instrument any Vein might be safely and securely opened if it swell upon a Ligature though it have an Artery Nerve or Tendon immediately under it Forasmuch therefore as never any harm happens in Blood-letting unless a Vein be prick'd through or slipping aside the Lancet be put too deep into the part the Fabrick of this Lancet is such and ought to be so put into the Vein as both may be easily prevented For the Lancet is so contrived that it is not cutting on each side unless it be near the point but is purposely blunt and made round on the lower side which is to be applied next to the skin that it may more easily slide over it as it appears by the following Table in which a the Lancet b the place where the upper edge
oftentimes wholly cures the King's-Evil Take Oyl of Myrtles and Bayes of each half an ounce Ointment of Martiaton an ounce Quicksilver extinct with Flower of Brimstone six drams Make it into an Ointment Let the Scrophula be annointed with it twice a day and if they are not consumed at least they will be diminished but the Chirurgeon must look into the Patient's Mouth each day lest upon the continual use of Mercury there follows a Flux which causes a swelling of the Tongue and Jaws The Plaister of Frogs with Mercury is likewise good here Or Take Gum-Caranna an ounce crude Mercury extinct in Turpentine three drams Make a Plaister If the Tumor he painful there may be added to this Plaister a dram of Opium which hath the virtue of resolving and easing pain and is not cold but hot Suppurating Medicines are set down in the second Chapter and Corrosive in the foregoing Chapter In Suppurated and open Scrophulaes this Ligament is much esteemed Take Oyl of Bayes Ceruse powdered and allayed with Aqua-vitae of each an ounce Roch-Allom half an ounce Salt two drams Make it into an Ointment CHAP. XI Of a Bubo BUbo is a Tumor besides Nature of the Glandules from impure Blood Red Painful and hard Difference Where little and not painful and easily brought to Suppuration 't is called Phyma but where there is more of Choler in it Phygeton in the Arm-pits Panus behind the Ears Parotis The one Malign or Pestilential the other not sometimes contracted from unchaste Embraces then 't is called a Venereal Bubo Cause is Blood never alone but always mixt with some other preternatural Humor Signs are Redness about the Glandules pain heat tension hardness pulsation and sometimes a Fever The Liver and Spleen according to the opinion of the Ancients discharge themselves into the Groins the Breast and Heart at the Arm-pits the Brain at the Glandules of the Ear but now far other use is attributed to the Glandules Of which there are several Tracts written and we shall give our Opinion in another place Prognosticks The Bubo that is not Malign is not dangerous except it be long discussing or suppurating and then fear lest it Fistulate In the Arm-pits it is sooner brought to maturity than in the Groins and here sooner than behind the Ears On the contrary a Malign is for the most part a sign of sudden Death although all outward signs may appear well The Venereal is not mortal but of hard Cure and for the most part precedes the Pox chiefly when by Bleeding or the use of repelling Medicines the Matter is returned from the External into Internal parts Cure Diet the same as in a Phlegmon In a Benign Purging is necessary provided it be not with too strong Medicines Bleeding except a great Fever or a Plethora require I admit no more of it here than of Repellent Medicines for 't is unseemly that Natures Assister should return that into the interior parts which Nature her self did eject which for the most part is Critical Sweating in all Buboes profits much Scarification hath no place here except in Malignant nor Leeches but where very much inflamed The External Cure is to be managed so that the Humor may be dissipated with Resolvents which by reason of the frigidity of the Glandules are required the stronger adding also Attractives to them for in all I suspect lest the Matter be not perfectly thrown forth But in a painful Bubo 't is first necessary to ease the pain before you come to any other Medicines In extream Pain Take Musilages of the Seeds of Flea-wort an ounce and half the Yolk of an Egg Saffron a dram fresh Butter half an ounce Make it into a Liniment Or Take Leaves of Mallows an handful Meal of Marsh-Mallow Roots and Fenugreek-seeds of each two ounces Barley-meal an ounce Ducks-grease Oyl of Dill of each half an ounce Boil them in Milk to the consistence of a Cataplasm Resolvents are above described Attractives shall be presently set down If it yield not to discussion Suppuration is to be endeavoured which is of all the safest Method Being suppurated let it forthwith be opened but rather by Incision than Cautery And so let it be kept opened until the whole Tumor be dissolved In Children for the most part we commit it wholly to Nature only prescribing a good Diet and forbidding the often touch of the part affected with the hands or we apply the Plaister of Diachilon or of Musilages 't is also often cured by the only using of Oyl of Olives Rape Camomil or white Lillies In a Pestilential Bubo neither Bleeding or Purging whatsoever others say must be used Sudorificks and Refrigeratives are convenient outwardly Attractives in the beginning are necessary Attractives Roots of Aron Briony Birthwort Pellitory of Spain Dittany Cresses Virgins-Flower Leeks Nettles Garlick Onions Figs Mustard Gums Galbanum Ammoniacum Euphorbium Succinum Cantharides Castor Ox gall Pigeons grease and Goats-dung Quick-Lime Nitre Brimstone Leaven Black-sope Plaisters of Diachilon Oxicroceum Thereacle Mithridate Take Roots of Marsh-mallows an ounce Onions two ounces Elder and Camomil-Flowers of each a pugil Figs N o xij Fenugreek-meal two ounces Pigeons-dung two drams Thereacle three drams Make a Cataplasm Or Take Roots of Pellitory of Spain Mustard-seed of each two scruples Salt two drams Treacle three drams Gum Ammoniacum dissolved in Vinegar as much as sufficeth to make a Plaister Many take a Hen or Frog divided in the midst and apply them warm to the affected Part often changing them Some apply to the Part the Breech of a live Hen or Pigeon the Feathers being pulled off Others take away all by Incision which is very dangerous and not to be permitted But they proceed best who forthwith in the very beginning apply a Vesicatory to the Bubo then the following Morning or Evening open the Blister and afterwards dressing it with Attractives This is of great Use and of much Esteem Take the Plaister of Diachilon with Gums of Musilages of each half a pound Ointment of Basilicon four ounces Mustard-seed three ounces Make a Plaister More of the Cure of a Bubo look in our Description of the Plague In a Venereal Bubo you must neither Bleed nor Purge as long as there remains any hope of Curing it by External Remedies lest the Malignant Humors which Nature threw out should be returned again into the Body and so occasion the Pox But Suppuration is to be endeavoured by all means and the Suppurated Tumor forthwith yea although the Matter be not perfectly concocted is to be opened if it is tough as for the most part it is Attractives are to be applied especially Cupping-Glasses they not being sufficient when the whole Mass of Blood is infected the Cure of the Pox is to be prescribed often using this following Decoction Take Roots of China Sarsaparilla of each three ounces Polipody an ounce Bark of Guaicum three ounces Senna two ounces Agarick Trochiscatum two drams Cinamon two drams Infuse in a sufficient
of others if thou dilligently require of what parts the Fabrick of thy Body consists to this end first we will shew the simple parts and their use then after the division of the whole Body the compounded Parts The Chirurgical use Seeing 't is very necessary even at first sight that thou shouldst know the nature and temperaments of Men because they give the Rules of what is to be done in the curing of each Disease we have thought it convenient in the very beginning of this Treatise to describe their Signs The Sanguine abound with Hair but lank and yellowish in process of time declining into blackish handsom red cheek'd freshy strong When young addicted to Venery not enduring â—â—â—ours easily sweating phthisical affable in their Conversation and Discourse not suspicious equally prone to laughter and tears they sleep soundly their dreams are pleasant Pulse is great and strong Urine yellowish and in great quantity soluble They hate Women and except in their company seldom think of them They bear Bleeding provided it be at a fitting time and in a convenient quantity otherwise they easily fall into a Dropsie Strong Purges to wit Euphorbium Scammony Colloquintida and those that are compounded of them they cannot bear though gentle Medicines easily as Cream of Tartar Manna Tamarinds Pruines Syrup of Roses with Senna Syrup of Succory with Rhubarb Pulp of Cassia Electuaries of Diacatholicum Lenitive c. As they easily fall into a Disease so they quickly again recover The Cholerick have black Hair and for the most part curled lean but very strong Coition profitable they are judicious and swift in action avoiding idleness they trust neither the words or gestures of Men soon subject to Laughter if the thing require it otherwise grave When irritated addicted to strike more inclined to Drink and Watching than to Eating and Sleep their dreams are of Fire Thunder Quarrels Battels Pulse strong quick and great Urine high-coloured as also their Excrements Choler requires not Bleeding yet permits it if there be a quantity of Blood joined with it but it must neither be excessive nor oftner repeated than just necessity requires lest the Choler shews its Malignity gentle Purges relieve it but strong irritate it it produceth vehement and dangerous Diseases and for the most part short Phlegmatick have long Flaxen Hair which easily falls off and as easily grows again Pale-fac'd cold and weak Body long ere they desire Marriage and soon debilitated by it sloathful unfit for Conversation not sollicitous about publick Affairs difficulty brought to Laughter or Anger which then lasts not long They eat and drink little prone to sleep Dreams are of Fish of the Water and Rain Pulse small and slow Urine pale and sometimes thin but generally thick and darkish the Belly soluble they bear not Bleeding except upon necessity they endure strong Purging their Diseases are long but not dangerous The Melancholick are almost destitute of Hair which is lank and black of a grim Countenance the whole skin livid lean slow and addicted to Venery prudent morose in conversation readier to give counsel to others than to themselves not subject to Laughter or Anger but long before appeased they eat and sleep much Urine copious Excrements little grievous Dreams Pulse small slow and hard Bleeding is hurtful Purging profitable the Diseases which it begets are stubborn and tedious and oftentimes more dangerous in the end than in the beginning Let these general Signs suffice in this place But 't is to be observed that the Temperaments are mixt and then the Signs are also Yea many Mutations Vices and Dissimulations as also Virtues and Ingenuity may be attributed to them which is your part judiciously to distinguish but we assent not to Galen who held that the dispositions of the Mind relie upon the Temperaments CHAP. II. Of the Parts in general· A Part properly so call'd is a firm limited Body which is nourished by other living Parts but doth not nourish having a peculiar use and operation for the advantage of the whole It is distinguished 1. Into the Principal Parts or or those not so Principal are those that perform some Noble Operation common to the whole Body as the Heart Liver Brain Testicles Those not so are those that serve the Principal and whence they are call'd their Servants as the Eye Ear Hands c. This distinction pleased some Anatomists many years since whom I much esteem yet not me For if the Liver and Heart are numbred amongst the Principal Parts because they elaborate the Blood for the advantage of the whole Body why is not the Tongue accounted a Principal Part also which is not only an Instrument of Speech by which we are distinguished from Beasts but also of Tastes by whose assistance we chuse those Aliments which are best which if wanting how the Heart and Liver could supply the Body with good Nutriment I see not The Brain governs all but how I beseech you If the Intestines did not perform their Orifice aright what would it effect How should we be esteem'd if like an Oister we should want Eyes and Ears How despised are the Feet and Hands yet in how many conditions do they serve For those not stirring both Chilification would be impaired and the Blood and the Spirits rendred thicker and the Brain made unfit for all actions In how short a time would the Limpha of our Body be corrupted if besides its own motion it was not also moved with the whole Body All things in our Body are joyned together as in a Clock one cannot be without the other neither is the most despicable Wheel less necessary than the Hand of the Clock itself without which it cannot be accounted a Clock 2. Into similar Parts and dissimilar A similar which divided into many parts yet whose single parts be of the same Nature with the whole Dissimilar are made up of more or less similars as the Hand Fingers Feet There are ten Similars found in the Body a Bone Cartilage Ligament Membrane Fibre Nerve Vein Artery Flesh Skin the eight former are made of Seed Flesh of Blood alone the Skin of both This Division is subject to greater difficulties than the former but seeing it is not convenient to reject it without the greatest confusion in the practice of Physick let us consider the thing it self committing the Disputes concerning the Name to the Schools Chirurgical Considerations 1. A Principal Part being affected or wounded renders the whole Cure dangerous therefore Prognosticks are not to be given here but with limitation lest the sudden alteration be rather ascribed to thee than to the Disease 2. Wounds of the similar Parts are less dangerous than of the dissimilar yea oftentimes they are sooner cured by simple Medicines than by compound the consent of the Parts by reason of the Vital and Animal Spirits is so great that scarce a Joint of the Finger being hurt can be cured without regard had to the whole Body In deed by the
'T is corrected by a large-mouth'd Cupping-glass outwardly applied upon the depressed Cartilage and being there fixt let it remain till breathing is hindred then suddenly remove and the Cartilage oftentimes at the first time returning again into its natural place which if it appears not to do the Chirurgeon must repeat this Operation once or twice then having embrocated the Part with Oyl of Roses and Myrtles apply this Plaister to the Part which must remain there several days Take Bistort-Roots Cypress-Nuts of each a dram Mastick Frankincense of each half a dram Balaustians a scruple Oyl of Nutmegs Exprest one dram and an half Naval-Pitch and Turpentine of each enough to make it into a Plaister CHAP. V. Of Ligaments A Ligament is a Similar Spermatick dry part adhering firmly to the Bones tying the parts of the Body mutually together Difference Some are Broad and Membranous some Round and Nervous 'T is here to be observed that the Names Membranous and Nervous are much used both by Writers and Practitioners and hath deceived many of them for 't is requisite to know that here it hath regard only to their external form not their internal essence for the Ligaments both the Membranous and the Nervous are void of Sense which they would not be if they were composed of their true substance of Nerve or Membrane There is no Ligament hollow if you except the slender Ligaments of the Womb and are all destitute likewise of Sense of Motion as from themselves Use is to connect the parts of the Body especially the Bones and preserveth them from continual Luxation Chirurgical Considerations 1. Ligaments hurt by reason of their want of sense seldom draw other parts into consent and by the use of drying Medicines are easily cured I cannot but again in this place taught by Experience commend the Restaurative Powder of which this is the Description Take Roots of Comfrey the greater Aloes Succotrine Calcis vivae of each two ounces Mastick Mirrhe Mummy of each two drams Precipitate two ounces Make it into a Powder Here diligently at the first time is the weak heat of the Ligaments to be considered seeing it may give occasion to a copious collection of Humors and other grievous Symptoms 2. The Ligaments also are not seldom Relaxt Yea although the Ignorant do contradict sometimes they are so much extended that they may give way to a Luxation which the Sciatick pain hath more than once given us example of in such a case external Bleeding and Purging profit much outwardly the Application of corroborating and discussing Topicks The following Plaister is excellent Take Stiptick Plaister of Crollius an ounce Oyl of Earth of Tiles of each a dram Make it into a Plaister to be spread upon Leather CHAP. VI. Of Membranes A Membrane is a Similar Spermatick Part broad soft dilatable white investing the Parts and carrying sense to them Difference Some are very thin others thick some fleshy but for the most part not The Parts which invest are properly call'd Membranes those which contain the Humors Tunicles and those which cover the Brain Meninges It is endued with sense from itself for all Membranes are sensible yea the Nerves themselves owe their sense to the Membranous substance of them Membranes therefore only are the true Organs of feeling they serving the Animal Spirits to this purpose Use is 1. To invest the Parts of the Body 2. To defend it from Injuries 3. To keep them united 4. To strengthen them 5. To give them sense 6. To close the Mouth of the Vessels that the Nutritious Blood be not carried too suddenly into the Part or out of it into the Vein it self 7. To separate the Parts Chirurgical Considerations The Membranes being so very sensible they cannot bear sharp Medicines they are not endowed with great quantity of Blood whence when they suffer a solution of continuity they are not easily united again But I have observed oft entimes that by the Muscles and the assistance of the Quittour they are joyned together as in the Bladder it self whose Wounds and Ulcers otherwise are esteemed incurable CHAP. VII Of Fibres A Fibre is a Similar Spermatick Part dispersed through the Skin Flesh and Membranes to make them the stronger and being naturally distended to contract again into the same manner Differences are right oblique and transverse and some round the right attract the oblique thrust forth transverse retain round constrain but this they do not so by their own singular virtue as by the common virtue of the Member which they serve and from whom they have their sense and nourishment for of themselves they are senseless Use is to strengthen the Membranes Skin and Muscles and when dilated to reduce them into their natural state Whether the Blood it self hath Fibres as many have delivered and as it seems very probable to us shall be explained in another place Chirurgical Consideration These offer nothing worthy consideration except that when they are wounded the consolidation of the Flesh and Skin is the longer and there is a greater stiffness of the Muscles about the place and makes them difficulter to contract and extend The Ductus of the Fibres is diligently to be observed by them which are to make any curious Incision CHAP. VIII Of Veins A Vein is a Similar Spermatick Membranous long hollow Part every where joined by Anastomoses to the Arteries receiving the Blood wanting further Concoction from them and carrying it to the Heart and Liver Difference Veins of a four-fold condition are found in the Body 1. Vena Cava 2. Vena Porta 3. Vena Pulmonalis 4. Vena Lacteae Of the last of which a more convenient occasion will be offered to treat of in the following The Venae Cava and Porta take their beginning from the Liver There are those which would have them come from the heart from a weak Argument taken from unborn Embrio's But where I find many Branches inserted in the Liver few or none in the Heart yea I have observed that it hath not entred into the Heart it self but only to be joined to its right Auricle I rather embrace the old Opinion willingly granting those honours to the Liver that I think belongs to it That the Roots of the Vena Cava and Porta were united by mutual Inosculations the old Anatomists perswaded themselves but the curious Inquisition of the Moderns hath both found out and clearly demonstrated that they mutually touch one another but not so united that the Blood can pass out of one into the other for the extremities of the foresaid Vessels by means of the Parenchyma of the Liver do so mutually consent that Milk or any liquid thing cast into the Vena Porta with a Syringe finds an easie passage into the Vena Cava without either an injury of the Veins or the Parenchyma Concerning which read Glisson Anatom of the Liver pag. 272. Veins have only one Tunicle with many Valves within especially in the external Joints They are nourished
the Arteries to be conveyed through the whole Body every part of this Blood nourisheth those parts which are of the like temperament with it self the Hot part of it nourisheth the Hot the Dry the Dry the Moist the Moist c. that which is here not well concocted must be brought back again to be perfected Why we say that the Veins are not sufficient and the passages not commodious enough to perform the same whose Office we know is to bring back to the Heart the Blood not sufficiently concocted the Reason is that the Water always remaining in the Vessels rendered the Blood too thin so deprived it of its natural consistence and strength From all those so clearly and distinctly laid down it sufficiently appears what the CIRCULATION OF THE BLOOD is to wit a continual motion of the Blood out of the Arteries into the Vena Cava and Porta to the Liver and Heart that in them it may be fitted for the Nutrition and the life of the whole Body Out of the subtilest part of the Blood are the SPIRITS produced which are two-fold 1. Vital which begotten in the Heart carry life to the parts of the Body 2. Animal who out of the Vitals elaborated in the Brain impart Sense and Motion to the Body The Natural at the same time that the Circulation of the Blood was found out vanished Chirurgical Considerations 1. The Ductus Salivales when the string of the Tongue is to be cut or the Ranine Vein to be opened or any other Disease of the Tongue that is to be cured by Manual Operation warn you to have great care of those little Glandules in which they end that they might not be hurt with the Launcet lest there follow a continual spitting The great Glandule also of the Neck from whence these Ductus's take their rise when it is inflamed admits not of the use of Mercury for from hence a dangerous Salivation may very easily be raised 2. The Lacteal Veins either the greater or the lesser are oftentimes from a Contusion or Wound so greviously hurt that they cannot carry the Chile to the Heart and though the wound be cured with great diligence care and speed yet the Patient will fall into a Consumption whence follows Death inevitably This Truth will defend Chirurgeons from many Calumnies In Children and older People is often perceiv'd an induration and inflamation of the Abdomen the cause of which is the hardness of the Mesaraic Glandules which allow not passage for the Chile to the great Lecteal Vein except the very thinnest of it whence the flesh of the Muscles wasts the Body becomes heavy and weary and at length a Feaver and a wasting of the whole Body This evil I use to remedy without any great trouble with this External Liniment Take compound Oyntment of Marshmallows Ointment of Sow-bread of Martiaton of each two drams Oyl of white Lillies of Camomile of each three drams Mix it into an Ointment Inwardly the following Troches are excellent being continually used the whole time of the Cure Take prepared Steel prepared Crabs-Eyes of each a scruple Vitriolated Tartar half a dram Sal Prunella xvj grains Species Aromatici Rosati a scruple white Sugar two ounces Make them into Troches according to Art In this case Purging is not to be used but with Cassia Cream of Tartar and Laxative Syrups for the Glandules will not bear strong Purges 3. The Blood taken out upon the opening a Vein oftentimes after some few hours space appears very dry and destitute of all Serum which for the most part is ascrib'd to its too great Heat and Adustion but this Argument is very invalid for if the same day the same or another Vein be again opened there will be found a great quantity of Serum in the Blood therefore the true Cause is to be deduc'd from the Circulation of the Blood but especially in the Lymphatick Vessels which at that time draws the Serum and Humidity and so leaves the Blood dry It very often also happens that the Body becomes Tumid Turgid and Languid upon which the fearful Physitian forthwith pronounces nought but dangers When with the use of Internal and External Sudorificks the Patient in a short time may be cured The Cause of this Disease is not from the intemperature and debility of those parts the Ancients call'd Noble for it may easily be distinguished from the Dropsie which these parts occasion for although the sick persons are very dull and weary yet are they not anxious but breath free and the Belly swells not much In the Face and Joynts especially is a watry Matter collected but if the swell'd parts are compressed by the Finger we perceive much less Serum to be contained in the parts than in a true Dropsie from whence those that understand not the true Cause are wont to ascribe this Inflammation to wind But the Lymphatick Vessels when comprest broke or by any other way obstructed so that the natural motion of the Lympha is hindred occasions this evil 1. The Circulation of the Blood requires all venomous and deprav'd Humors which are thrown out either by Nature it self or that outwardly happen to the Body at the very first instant forthwith to be expelled out of the Glandules and the Skin by the means of attractive Medicines lest that the whole Blood in a very short time be infected and the Heart it self opprest and suffer under it The which doth sufficiently declare how dangerous it is to open a Vein and to purge in a Venereal and Pestilential Bubo nay in all venomous Wounds as on the contrary how necessary it is to cast forth the offending matter by the use of Sudorifick and Attracting Medicines As moreover how that the invention of the Circulation of the Blood is of very great use in the Art of Physick CHAP. XV. The Division of the Body MAn's Body is most conveniently divided into the Venters or Regions and Joynts There are three Venters 1. The Head or the supream Region or Cavity to it is joined the Neck which is its prop. 2. The Thorax Breast or middle Region 3. The Abdomen lower Belly or lower Region The Joynts are the two Arms and the two Legs Chirurgical Considerations We divide the Body after this manner that it may be known what place each part of the Body ought to keep to those that read the following every thing will become more manifest But there is so great consent of all the Parts so great concord that no part may be by it self consider'd without a consideration of the whole therefore I think it necessary that in a few words the foundation of this mutual consent be here declar'd 1. In every part is required a natural temper for the Liver being too hot the Stomach too cold the Brain too dry c. the whole Body must be out of order 2. A sufficient number for in the Hand if the least Bone Tendon or Artery c. be wanting forthwith its
the Body from the Collar-Bones to the Feet which arise not only out of the Brain from the Parvagum but also from the Spinal Marrow and from the fifth and sixth Vertebra of the Neck Of the other Vessels we have already treated Chirurgical Considerations The Pleura is not only subject to Inflammation upon which follows a Pleurisie an Empiema and Impostumation but also a certain pain which a salt Humor produceth This may be distinguished from a Pleurisie because here is a dry Cough yet no Fever also free breathing enough I have used to remove this by Bleeding and Sweating and if you fear a Pleurisie apply outwardly this Plaister Take Marrow out of an Oxes-bone Ducks-grease of each three ounces the Mussilage of Marshmallows Linseed Fenugreek-seed of an ounce Frankincense Mastick of each half an ounce Oyl of Nucista exprest two drams yellow Wax as much as sufficeth to make it into a Plaister 2. Mediastinum hath not so great a Cavity in Man as in Dogs and other creatures yet it happens sometimes that a purulent matter descends between the two Membranes of it which can by means be evacuated by the Lungs therefore we are forced to perforate the Sternum with a Trepan that so through the made Orifice by the use of Tents Spunges and other Instruments the Matter may be discharged 3. In that kind of Quinsey which we above call Cynanche where the Patient is almost suffocated we remedy by Laringotomia or opening the Wind-pipe the Disease it self is far more dangerous than this Operation therefore it would be well if it was oftener practised nevertheless there is required a diligent consideration that the other parts to wit the Lungs Pleura Gullet c. be not also enflamed or already full of matter which may frustrate your labour afford cause of scandal but every thing being well weighed the Operation is to be performed in this manner Let the Head be a little bent backwards that the Wind-pipe may the more plainly appear and the annulary Cartilages recede the further the one from the other then divide the Skin according to the length of the Larinx unto the hollow and let a stander-by with his Fingers pluck open the Skin of each side that the Chirurgeon may see the two long Muscles Sterno hyoidei which he must remove a little asunder either with a Knife of Wood or Bone then the Larinx appearing he must make his Incision with a Launcet in the middle between the third and fourth annulary Cartilage taking great care that he hurt not the Cartilages themselves upon the Breaths coming forth take out the Knife and put a Silver Pipe into the Wound which must not be so long as to reach the hinder part of the Wind-pipe lest it cause a continual Cough the danger of suffocation being over which for the most part happens to be about the third or fourth day or at least ought then to be the Pipe must be taken forth and the Wound is to be cured in the ordinary manner according to Art from which it differs not 4. 'T is no new thing for Worms to generate in the Pericardium which except kill'd corrode the very Heart it self They may be destroyed with a Decoction of Scordium Wormwood Centaury c. drunk twice or thrice a day Concerning the Wounds of the Lungs Heart and Diaphragm see our Chirurgery A Wound of the Gullet is cured after the same manner as that of the Stomach The End of the third Book of the third Part. The FOURTH BOOK Of the Lower Belly CHAP. I. Of the External Parts of this Belly THE lower Cavity properly call'd the Belly is divided into three parts of which 1. Is the Epigastrium each side of which is call'd Hypochondria 2. The Region of the Navel whose sides are call'd Ilium 3. Hypogastrium the sides of which are the Groins The lower hairy part is call'd Pubes The Abdomen under common Teguments hath ten Muscles of each side five very necessary for the exclusion of the grosser Excrements contained in the Guts they are these 1. Obliquely descending which in the upper part the Navel in the lower in Man the process of the Peritonaeum In Woman the long Ligaments of the Womb perforates 2. The Oblique ascending 3. The Recti or straight 4. The Pyramidal 5. The Trarsverse In the middle of the Abdomen between the two straight Muscles ariseth the Linea Alba or White-Line from the meeting of the broad Tendons of the other thin Muscles which is very sensible Of the Veins Arteries Nerves both of the outward and inward parts of the lower Belly we have already treated of in the first Book as likewise something of the Bones But the more curious Examiner meets withal first five Vertebra's of the Loins which are very full of holes and greater and thicker than all the rest Next to them follows the Os Sacrum which is triangular in old people being only of one Bone but in young consisting of five or six To this is joyned the Os Coccygis bent in Women more outward in Men more inward On the sides of the Os Sacrum is the Os Innominatum or Coxae consisting of three Bones joyned together with a Cartilage Of these 1. Is the Os Ilium much thicker in Women than in Men. 2. Os Pudis more easily separable in the fore-part in Women than in Men. 3. Os Ischion or Coxae furnished with a large Cavity which is call'd Acetabulum or Pixis appointed to receive the head of the Thigh-Bone Chirurgical Consideration The outward Division of the Lower Belly plainly declares what Internal Parts may be affected In the right Hypochondrium the Liver is situated extending it self beyond the Bastard-Ribs two fingers breadth to the Sword-like Cartilage of the Sternum In the middle lies the Stomach extending it self to the softer parts of this Belly so that it reacheth four fingers breadth beyond the Bastard-Ribs Beyond the soft places near the Kidneys lies the Spleen In the middle of the Vmbilical Region and about it lies the Small Gut which being wounded is most dangerous In the right side about the Kidney the Gut Colon takes its rise transversly running between the Stomach and Navel to the left Kidney where winding downwards and becoming narrower is the frequent receptacle of Wind and whence long pain and great tension which is undeservedly attributed to the Spleen on the other side the Intestine rests upon the Mesentery as doth the Stomach upon the Pancreas In the middle of the Hypogastrium are the Bladder and Womb placed and under them the Intestinum rectum On the Side lie the Spermatick Vessels and the Glandules in which both benign and malignant Buboes are produced But all these Parts cannot be wounded except the Peritonaeum and Omentum be first perforated yet in many men the Omentum descends not below the Navel and contrariwise in others it reacheth to the Os Pubis it self CHAP. II. Of the Internal Parts of the Abdomen THe first of
of some Humor which renders the Cure very difficult For this I commend the often praised Restorative Powder 3. A great Tendon is inserted in the Calcaneus or Bone of the Heel which being wounded or much contused brings Convulsions and death it self About this place comes Kibes whose cause is intense cold or heat with driness Here first are observed Fissures in the Skin then follows an Ulceration All fat things and Plaisters profit here especially the following Take Powder of Galls of round Birthwort of each half a dram red Lead a dram Mercury sublimate six grains Litharge Mirrhe of each a dram and half Camphire a scruple Franckincense two drams green Wax as much as sufficeth to make it into a Plaister In the room of green Wax you may take the Fat of Deer or of Rams 4. The Fingers or Toes being frozen must be rubb'd with Snow or with a bruised frozen Turnep then this following Plaister is much commended Take Hogs-grease fresh Oyl of Olives of each an ounce white Wax two ounces boil them a little and make a Plaister 5. Issues are often made in the Joynts we have formerly declared the place In the Arms between the Muscle Deltois and Biceps in the Thigh two fingers breadth above the Knee in the inside in the Leg the uppermost two fingers breadth below the Knee the lowermost two fingers or three above the Ankle That you may make these Issues without pain instead of a Conclusion take this Caustick which works without pain which is also very much to be commended in sordid and cancerous Ulcers and in Excrescencies Take Crude Brimstone white Arsnick Crude Antimony of each two ounces the Brimstone being melted by a gentle fire and stirred about with a Spatula add the Arsnick and Antimony powdred and mix them whilst they are incorporated with the Brimstone and look red Afterwards Take of this Mixture an ounce Caput mortuum of Vitriol half an ounce Mix them and make a Powder let it be washt six times in Spirit of wine and dried for your use A TREATISE OF THE PLAGUE THE Plague is a Disease whose nature is not to be comprehended by us the Cause thereof seems to proceed from a Spirituous and Infectious Vapour which is powerful enough to make a sudden dissolution of the consistence of the Blood by which means the Heart is deprived both of strength and life I do assert that the Nature of it is not to be comprehended by us as well because it is a Punishment inflicted on us by the immediate hand of Almighty God who vouchsafes not that his Incomprehensible Wisdom and Essence which is sometimes faintly described to us should be narrowly pryed into by his creatures as also that it is in it self so mutable that if we should seriously recollect our selves and recount the several Pestilences wherewith all former Ages have been visited we shall not thereby be able to instance in two of that whole number which have agreed with each other in all circumstances From whence we may easily infer that in the Cure of this Disease an Experienced Physician may much more safely follow the Dictates of his own Reason than adhire strictly to the Method Prescriptions of others For although it doth sometimes by the more remarkable symptoms sufficiently evidence it self yet we cannot likely discover its Nature and Essence although we should the most industriously attempt it But that we may cautiously enquire into it we must know that it is sometimes not accompanied by any Fever And it is necessary that what Physician soever is ignorant of this should either by perusing good Authors or his own Experience acquaint himself throughly with it I have been sent for to several Patients my self who although they appeared otherwise in good health not refusing their meat nor disturb'd in their sleep have nevertheless had Buboes arising in their Groin on their Neck under their Arm-pits or behind their Ears which have apparently discovered a greater Malignity than could be discerned in those Buboes which in other persons have been attended by a violent Fever And many hereupon who have been incredulous and lightly regarded the cautions which I have given them upon this account have with great danger to themselves experimented that as soon as those Buboes have sunk down the Pestilential Symptoms which have appear'd have been very dreadful and much more dangerous than in those that have carefully used the means prescribed to them who have been also much more easily and speedily cured than the other Sometimes the Plague is accompanied with a Fever and again there are some Pestilent Fevers without the Plague To distinguish this Fever from the Plague I used to observe that they that are seized with it complain of pain in their Head and Stomach which sometimes is dispersed over the whole Body sometimes it confines it self to the Arm-pits the Neck the Parts behind the Ears or to the Groin To outward appearance there is not the least swelling If the Patient by such means as is requisite be provoked to sweat at the beginning of the Disease the pain utterly ceaseth and in a few dayes he will be perfectly restored to his health the Disease not having at all discovered it self by any outward Symptoms Why such a Fever should be accounted a Species of the Plague I see no reason But there is no one but will confess it to have seized on that Body on which Buboes Carbuncles and Spots do outwardly appear The cause of the Plague is either Internal or External but unto which soever we impute it it is necessary to conclude that there is in it a power of dissolving the natural Consistence of the Blood and depriving the whole Body of its strength As to the Inward Cause which is Meat and Drink it is evident to all that it cannot produce in any Body whatsoever so great sudden a change but it is most certain that by a long continued course of bad Diet the Blood may by degrees be after such a manner dissolved weakned and corrupted that some part of it assuming to it self a malignant quality a man may be surprized by a sudden Disease sometimes be deprived of life it self which hath been observed in sick persons at several times when there hath been no contagion in the place nor any suspected who have been troubled with perfect Buboes and other Symptoms of the Plague much more intolerable than others have been at any time when the Air hath been infected As to the outward Causes every one confesseth that there are such but their Nature is known but to few The Chymists who are able by the force of Fire distinctly to separate the Parts of simple Drugs endeavour to find the Original of the Contagion in a Volatile Salt which suddenly dissolves the fixed Salt of the Blood which hath indeed some appearance of truth though it will not be relished by all men If you enquire into the Cause hereof from others their
30 hours or more been troubled with the Spots at length after exceeding great pain accompanied with a Delirium he voided first Blood and after that a purulent matter through his Yard by which means he was restored to his health I conjectured that there was a Carbuncle in the case which seized not on the Membranous part of the Bladder but on the Neck thereof As to the Cure Blood-letting is very prejudicial to those that already have the Plague and dangerous to such that would prevent it The Poison oftentimes lies hid within the Bâ—dy for some dayes weeks or months before â—â— discovers it self by seizing on the conveyances of the Blood Wherefore I would advise you seriously to consider if by opening a Vein you invite it immediately to the Heart whether the diminution of Blood Spirits and Strength which is effected by this means be not the Cause why the Heart is suffocated and deprived of that vigour which it should make use of to repulse the Enemy I confess some Experienced Physitians of good credit have reported that in hot Countries there is no better means for restoring a Patient visited with the Plague unto his health than that of opening a Vein provided it be done cautiously and at the beginning of the Disease but whosoever have attempted it in colder Climates have quickly learnt by experience that it ought to be forborn Purging which is oftentimes very necessary in other gentle Diseases is excluded by the Malignity of this But every one is not quick-sighted enough to discern when it is requisite to be done and when to be forborn Moreover it is evident that in a Malignant Disease the Physick which is administred to a Patient ought to be more mild and gentle than at other times for besides that the Body cannot then bear strong purgations a Dysentery is oftentimes the consequence of them I have when I have been fully perswaded that there was no Malignity in the Disease oftentimes used this or some such like Potion with good success viz. Take Rhubarb a dram and half Senna two drams Cream of Tartar a dram Scorzonera-Roots half an ounce Aniseeds half a dram Boil them in Holy-Thistle-Water and to three ounces of the strained Liquor and Syrup of Succory with Rhubarb six drams Spirit of Salt a little Confection of Alkermes a scrupel Make it into a Potion I never adventured to prescribe any thing Purgative to such as have been taken with the Plague before the fourteenth day at which time the Fever and the other Symptoms of the Disease would be abated There are some who have attempted it while the Carbuncles remain purulent and before the Bubo is perfectly cured But I dare not advise any one to follow that Method whatsoever Remedies they administer at the same time which may be intended specifically against the Plague But if it happen that the Patient for several days be very costive and troubled with a pain at his heart and hopes to be relieved by Purgation It is to be considered that the Venom of the Disease and not the Costiveness is the cause of the pain at the Heart it is therefore most requisite to make use of Sudorificks to corroborate the Heart and not to concern your self for the costiveness of the Body but if you desire to open it a little it is better to make use of a Suppository than a Glyster which is not altogether so safe but hath been prejudicial to many on this occasion and to others it hath done but little good and not at all opposed the Malignity of the Disease But to such as will not take this advise which hath been very confirmed by experience and several good Reasons and will still persist to make use of Glysters it is fit however that they forbear to prescribe Scammony as an Ingredient especially to Women in the time of their Flowers Juleps are in this case very necessary but all persons may not make use of them nor any at all times I am never wont to prescribe them without joyning with them some Sudorificks which will appear hereafter and this I take to be the safest course for if the sick person should make use of such things only as refrigerate while he sweats freely the Sweat would oftentimes strike inward and the Venom would be conveyed to the Heart from whence would follow sudden Death There is no means more requisite than that of Diaphoreticks and Cordials especially those that are acid which produce such effects as are certain and therefore the more laudable for they rectifie the Mass of Blood and free it from the venom which infects it They dissolve the pituitous Matter which is lodged in the Stomach and the Entrails and correct the Choler which in this Disease is the cause of much mischief Nevertheless the several disguises of this Disease and the vanity of the Symptoms which attend it do require that they should be often changed since when the Disease is more gentle those things are not to be used which would do good service in an accute one Medicaments against the Plague Roots of Zedoary Butter-Bur Angelica Ditamny Galangal Vipers-grass Gentian Master-wort Lovage Burnet Orrise Florentine and ours China Sarsaparilla Leaves of Rue Scordium Sage Holy-Thistle Swallow-wort Wormwood Southern-wood Centuary the lesser Valerian Sorrel Fluellin Balm Marjoram Rosemary Thyme Mint Flowers of Borage Bugloss Violets Roses Marrigolds St. John worts Rosemary Indian-Spikenard Jesamy Seeds of Citrons Oranges Rue St. Johns wort Anise Coriander Lovage Fruits Citrons Oranges Walnuts Figs sharp Cherries Pippins Ribes sowre Pomegranates Barberries Spices Musk Ambergreece Civet Benjamin Storax Calamita Cinamon Mace Nutmegs Cardamums Camphire Animals or their parts Flesh of Vipers Mummy Serpents Quails Thrushes Harts-horn Unicorns-horn Bezoar Stone of an Indian Hog Ivory Castor Precious Stones and Earths the Jacinth Granate Emerald Ruby Carbuncle Pearls Coral Bolearmenick Earth of Lemnos and Seal'd Gold Silver Salts Common brought lately from the River Nile which moveth Sweat most powerfully of Scordium of Wormwood Rue Self-heal Holy-Thistle Vitriolated Tartar Bezoarticum Minerale Threacle of Andromacus's Diatesseron Mithridate of Damocratis Diascordium of Fracastorius Confection of Alkermes of Hyacinth Species Liberantis Electuaries of the Egg Rob. of Currans of Barberies Conserves of Balm Mint Rosemary-Flowers Borage Bugloss Marigold-Flowers Troches of the Juice of Barberries of Citrons Out of all which you may make choice of such as you judge most fit for the purpose The Writings of Authors who have treated of this Disease will give you an account of other Compounds out of which you may chuse such as please you best I shall here propound such only as I have found to be most efficacious and which I shall constantly make use of till by experience I shall discover some others whose nature is more excellent and that the use of them may the more plainly appear I shall premise some Medicaments that some years since were prescribed by my self and those Learned Men Dr. Francis Sylvius